Extreme weight loss without stomach shrinking
Very obese Americans—those with a BMI over 40—often are not able to sustain sufficient weight loss to significantly reduce their risks of type 2 diabetes and other obesity-related diseases. “For getting to a healthy weight, bariatric surgery has been the most successful option,” says Caroline Apovian, MD, director of the Nutrition and Weight Management Center at Boston Medical Center and author of The Overnight Diet. Procedures such as gastric bypass and gastric band reduce the size of the stomach and dramatically decrease a person’s ability to digest food, typically leading to substantial loss of pounds.
“In the future, there will be less invasive devices that will be almost as effective as bariatric surgery,” says Apovian. These may include AspireAssist, a system that allows a person to remove about a third of her stomach contents after a meal before the calories and nutrients pass farther along the intestinal tract. The partly digested food leaves through a tube that is connected to a valve on the abdomen and gets dumped in a toilet. This system, already available in Europe, is undergoing clinical trials in the U.S.
Another weight-loss device, the Endo-Barrier, is also being used in Europe. It consists of a thin, sleevelike liner that is inserted via the mouth, then attached to the first portion of your small intestine, where it forms a physical barrier that prevents food from being absorbed by this part of your body. This change in the normal digestive process brings down blood sugar and makes you feel full on small meals. Both AspireAssist and EndoBarrier are inserted without risky general anesthesia.
A test for Alzheimer’s disease
Almost two thirds of Americans who suffer from Alzheimer’s are women. The disease is now diagnosed largely through a process of elimination. Using CT scans and MRIs, doctors rule out other likely causes of memory loss and behavior changes, such as a brain tumor. Currently a definitive diagnosis of Alzheimer’s can be made only after a patient has died, through an autopsy of brain tissue that confirms the presence of neurofibrillary tangles, which are twisted protein fibers, and amyloid deposits, which are hard accumulations of protein in the brain.
By 2028 scientists will probably be able to diagnose the disease in people before it causes symptoms. Research centers are trying out tracers that can detect abnormal amyloid deposits in the brain using positron-emission tomography (PET), a type of scan that captures images of brain activity. Amyloid plaque can appear long before Alzheimer’s symptoms do, says Hui Zheng, PhD, professor of molecular and human genetics at Baylor College of Medicine. The radiotracers being tested literally light up amyloid in the brain and will allow drug companies to track the progression of Alzheimer’s to see how medication affects it. The PET scans will also pick up the disease early. “If we can make this kind of test affordable, I have no doubt that 15 years down the road we will be using it for people with memory issues and even for healthy people,” says Zheng.
Earlier detection of Alzheimer’s—say, when the neurofibrillary tangles are just beginning to form—might lead to a drug that would clear away what Zheng calls “the cellular garbage” before damage to neurons occurs.
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